Active NPI
Kenya Chantel Miles, M.D.
- Occupational Medicine Physician
- Marietta, GA
National Provider Identifier
1568626018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Medicine Physician
- License
- 73432
- Practice address
- 3747 Roswell Rd Ste 204
Marietta, GA 30062-6227 - Phone
- (470) 956-4360
- NPI assigned
- Jul 14, 2008
- Last updated
- Mar 2, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Medicine Physician | 2083X0100X | 73432 | GA | Primary |
| Surgery Physician | 208600000X | MD039390 | DC |
Addresses
Primary practice location
3747 Roswell Rd Ste 204
Marietta, GA 30062-6227
Mailing address
805 Sandy Plains Road
Medical Staff Services
Marietta, GA 30066-6340
Phone (770) 792-5451
Other practice location 1
6323 Georgia Ave NW
Suite 105
Washington, DC 20011-1101
Phone (301) 485-8430
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kmiles402038@directwellstar.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 73432 | GA | MD | Occupational Medicine Physician |
| MD039390 | DC | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614643200000",
"number": "1568626018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 SANDY PLAINS ROAD",
"address_2": "MEDICAL STAFF SERVICES",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300666340",
"telephone_number": "770-792-5451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3747 ROSWELL RD STE 204",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300626227",
"telephone_number": "470-956-4360"
}
],
"practiceLocations": [
{
"address_1": "6323 Georgia Ave NW",
"address_2": "Suite 105",
"address_purpose": "LOCATION",
"city": "Washington",
"state": "DC",
"postal_code": "200111101",
"country_code": "US",
"telephone_number": "301-485-8430",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MILES",
"first_name": "KENYA",
"middle_name": "CHANTEL",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-14",
"last_updated": "2021-03-02",
"certification_date": "2021-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "GA",
"license": "73432",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "DC",
"license": "MD039390",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kmiles402038@directwellstar.org",
"affiliation": "N",
"address_1": "3747 Roswell Rd Ste 204",
"city": "Marietta",
"state": "GA",
"country_code": "US",
"postal_code": "300626227",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.